DEAR DR FOX: Thank you for discussing vaccinations for indoor cats in a recent column.

I never intentionally allow my cats outside, but two of them dashed out briefly in recent weeks, after which I found a flea on one. I don’t treat them all monthly for fleas, but I responded promptly with treatments for all.

Would you agree that flea treatments are also optional, depending on a pet’s environment? I’ve read of side effects of flea preventatives, as well.

I’m planning an outdoor enclosure for my cats with a pet door to allow them in and out at will. I am aware that there are chemicals available for treating kennels and surrounding lawn, which may be highly advisable.

Would my pets still be considered “indoor” cats? The enclosure would allow smaller animals to pass through, but not those of similar size to the cats, or larger. Are any outdoor animals hazardous to cats in such an enclosure? -- J.W., South Bend, Indiana

DEAR J.W.: I am glad you are going to put up a catio: an outdoor enclosure for your cats.

Many connect via a flap door to the house. Be sure the top is covered and at least partly provides shade and shelter. Sides should have at least a 3-foot fine wire netting or mesh around the bottom to keep small critters out. Put the catio on the sunny side of the house, on a cement base for easy cleaning.

If there are stray cats in your neighborhood, your cats could be at risk from heartworm disease, so discuss vaccination and other local outdoor-cat health risks with your vet. I would not use any long-acting systemic insecticides on your cats. A pinch of brewer’s yeast in their food daily, and good nutrition such as The Honest Kitchen freeze-dried cat foods, will help repel fleas.

Cat predators? I doubt a coyote or bear would try to break into a catio.

DEAR DR. FOX: One of our cats, Greg, has developed acne (by the looks of it) on his chin. It has gotten better over the last two weeks, and his hair loss/scabbing has decreased, but it is still an irritant for him. Any advice would be appreciated. -- J.F. Maple Grove, Minnesota

DEAR J.F.: Your diagnosis of feline acne is correct, judging by the photos you sent. This condition is quite common, and the first step is to cut the fur close to help keep the inflamed area dry between treatments. Applying aloe vera gel for five to 10 days, twice daily, or a hydrosol of diluted tea tree oil, can work wonders. Conventional treatment with corticosteroid and antibiotic cream is also effective.

Cats have scent glands and sebaceous glands around the chin and cheek areas, and lots of bacteria live naturally on the skin surface. What causes this condition may or may not be hormonal, or a dietary lack of some nutrients -- especially the essential fatty acids found in fish oil that are lacking in dry kibble. Some cats also develop chin lesions when plastic food and water bowls are replaced with ceramic.

THE KILLING OF EVERGREEN TREES A VERY UN-CHRISTMAS RITUAL

Millions of little evergreen trees will be killed this Christmas for the holiday/Holy Day celebrations, in imitation of a long-forgotten pagan ritual of dressing the symbolic Tree of Life in gratitude. It is time for all of us consumers to wake up and examine such cultural traditions and, in this instance, pledge to plant indigenous varieties of trees, ideally every spring. Communities should set aside land, including public grass-mowed parks and other public and corporate acres, for such plantings. This will do much to help arrest climate change and, hopefully, put an end to the wanton felling of trees for Christmas decoration. The holiday should be a time to revere and celebrate life rather than a time of thoughtless killing.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox’s website at DrFoxOneHealth.com.)

DEAR READERS: The lives of many animals, wild and domestic, have been lost in the apocalyptic fires in California that residents are calling the “new norm.”

Other ecological disasters, such as hurricanes, typhoons, earthquakes, tsunamis, floods and prolonged droughts, are also becoming the new norm in many parts of the world. The adverse consequences to biodiversity, communities and their economies are going to escalate as such climatic phenomena increase in frequency and intensity.

Disaster preparedness initiatives would be well-advised in many states and countries. These efforts should include the funding and staffing of facilities to care for affected animals, and to handle the subsequent environmental cleanup with a focus on ecological and agricultural restoration. Veterinary colleges and national and regional veterinary associations all contribute significantly to these efforts, along with animal rescue and protection organizations. These groups are always in need of public funding, and donations to certified nonprofits are tax-deductible.

The California Veterinary Medical Association Disaster Program (cvma.net) has centered its efforts on developing the California Veterinary Medical Reserve Corps, a group of veterinarians, registered veterinary technicians and office staff who volunteer to provide emergency vet care and expertise in all phases of disaster preparedness and response. According to UC Davis, the medical attention the animals receive is being funded by donations provided to the school’s Veterinary Catastrophic Need Fund.

The American Veterinary Medical Foundation, which is the charitable arm of the American Veterinary Medical Association, announced a donation of $20,000 to help animals affected by the California wildfires and the veterinarians treating them. The group’s National Veterinary Response Teams provide expert veterinary care to service animals, including security animals, during disasters and certain national security events. Organizations such as World Vets are involved in disaster-relief services abroad.

There are also everyday, non-disaster needs in many communities. One standout shelter and animal foster-care organization in urgent need of funding is Chicago’s Touched by an Animal (touchedbyananimal.org). Its unique mission serves to aid companion animals whose owners need assistance in the form of food and litter donations, vet care expenses, boarding and foster care. Many of the people they help -- the elderly, the hospitalized, the homeless, or those who are in transition (both financially and geographically) -- fall within the underserved, and sadly, often forgotten and dismissed, population.

DEAR DR. FOX: In need of a house cat, we got one from the cages at a PetSmart: an unusually light-colored female tabby cat.

We discovered that the cat was obese, and was being fed Diamond dry diet cat food; she also had sensitive skin and suffered respiratory irritation. Periodically, she would stop eating and be afflicted by vomiting and diarrhea. Though spayed, she also had discharge from her vulva, which she seemed unable to keep clean.

Our vet couldn’t really identify the problem, despite blood tests and the administration of antibiotics. The vet did prescribe prescription food for sensitive skin. Eventually, we began to suspect diet when the prescription cat food produced a significant improvement. We gave her supplements, too: Fortiflora and Tomlyn Immune Support. When the cat started to refuse the prescription food, we transitioned to Fancy Feast.

On reading your recent advice to another cat owner, we exchanged Fancy Feast for the Wellness brand of minced turkey, which we offer in several small portions, morning and evening. At other times, the cat is free to eat from a bowl of Meow Mix dry food that she seems to like; she wouldn’t touch the Wellness grain-free dry food.

After two years, we have a different cat. She appears a lot darker now that she’s thinner, since we don’t see her undercoat. She is trim, alert, active, bright-eyed and has a shiny, healthy-looking coat. There is no sign of skin or respiratory irritation, and no more unpleasant discharge.

Though not a lap cat, she is more amenable to petting now, and will come to sit close and rest her head on my thigh when I am sitting on the couch.

It was an expensive rescue that the cat desperately needed. All her troubles seem due to poor diet and long captivity in a small cage. And though Wellness is more expensive than Fancy Feast, she is eating much less, between three and six ounces daily. -- A.S., Tulsa, Oklahoma

DEAR A.S.: I hope all readers who have cats will take note of your important letter: a testimony of how dry kibble makes cats very ill with multiple health problems. Also, the veterinarian who first attended to your rescued cat should have suggested a wholesome diet and supplements to combat her various woes.

NEW CALIFORNIA LAWS: GOOD NEWS FOR ANIMALS

The State of California passed two new laws last month that will help protect animals.

First, California became the first state in the United States to ban fur. A bill recently signed by Gov. Gavin Newsom will make it illegal to sell, donate or manufacture fur products in California. The law applies to all clothing, handbags, shoes and other items.

The second law is the Circus Cruelty Prevention Act, which bans exotic animals in circuses statewide. California is the third state in the nation with such a ban, joining Hawaii and New Jersey. The law applies to exotic animals, including elephants, monkeys, lions, bears and tigers. The bill does not include dogs or cats, and does not apply to rodeos.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox’s website at DrFoxOneHealth.com.)

DEAR READERS: Dog ownership decreases a person’s overall risk of premature death by 24%, according to researchers who conducted a review of the available medical evidence.

The benefit is most pronounced in people with existing heart problems. Dog owners had a 65% reduced risk of death following a heart attack and a 31% reduced risk of death from heart disease, the researchers said.

“People who had a heart attack prior to getting a dog had even more reduction in mortality,” said lead author Dr. Caroline Kramer, an assistant professor of medicine at the University of Toronto.

That analysis was backed up by a separate Swedish study, which found that heart attack and stroke victims who own dogs have a lower risk of dying, particularly if they live alone.

Owning a dog reduced a heart attack patient’s risk of death by 33% if they live alone, and 15% if they live with a partner or child, according to data from the Swedish National Patient Register. Similarly, death risk for dog-owning stroke survivors was 27% lower if they live alone and 12% lower for those living with someone.

Both reports were published Oct. 8 in the journal Circulation: Cardiovascular Quality and Outcomes.

Part of the benefit is likely due to the physical activity that comes with having a dog, Kramer said. Prior studies have come to similar conclusions, and researchers say dog ownership has both physical and mental health benefits. (HealthDay News, Oct. 8)

DEAR DR. FOX: What’s the best dry food on the market that I can purchase for my two Jack Russells? -- L.L., Newark, New Jersey

DEAR L.L.: First, I trust that you are not considering feeding your dogs just dry kibble.

Many are inflammatory and nutritionally incomplete, and the “grain-free” formulations can cause other health issues. Please see my review of some manufactured pet foods, as well as my recipe for home-prepared dog food, on my website (DrFoxOneHealth.com).

I feed our dog some dry manufactured kibble such as Halo, freeze-dried dog food from The Honest Kitchen, and one of a number of varieties of good-quality canned dog food -- in addition to the home-prepared dog food. Variety is the spice of dogs’ lives!

FERMENTED FOODS GOOD FOR OUR DOGS -- AND US

There is a growing consensus among holistic veterinarians and other health care professionals and health-conscious consumers that fermented foods are extremely beneficial in helping maintain a healthy gut flora, also known as the intestinal microbiome.

Highly processed foods for humans, dogs and cats alike are lacking in the beneficial enzymes, vitamins, minerals and probiotics that fermented foods provide. These foods include miso, tempeh, probiotic yogurt, kefir and sauerkraut. Visit animalwellnessmagazine.com/fermented-foods-good-dogs for more details.

(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

Visit Dr. Fox’s website at DrFoxOneHealth.com.)